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Ear Infections


Otitis is the medical term for a group of diseases/bacterial infections that cause inflammation of the middle ear. The middle ear is the section between the eardrum and the inner ear which contains three small bones called ‘ossicles’ that transmit vibrations of the eardrum to the inner ear and allow us to hear sound.

There are five common types of Otitis:

1) Recurrent Acute Otitis Media

Acute otitis media is more common in children than in adults. The term ‘acute’ describes conditions which come on quite rapidly and are often accompanied by fever, headache and irritability and sometimes other symptoms for example diarrhea, vomiting and loss of appetite.

Up to 30% of children are affected by recurrent acute otitis media and need medical treatment. Treatment required vary depending on the exact form of otitis, and so an accurate diagnosis is very important.

2) Chronic Otitis Media

The term ‘chronic otitis media’ applies to the condition where infection has lasted a long time.

One possible cause of the condition is a cholesteatoma – an abnormal skin growth behind the eardrum, which is sometimes caused by problems with the tube connecting the ear and the nose (the Eustachian tube). Another possible cause is a perforated eardrum which has not properly healed.

In other cases, chronic otitis media may be caused by a previous nose/throat infection or where water has got into the ear, often from swimming or taking a bath.

The primary symptom is an ongoing discharge of pus, often with an unpleasant odour, although there may be no pain. Where chronic otitis media remains untreated, polyps may form in the middle and/or outer ear. These small growths can cause other issues, for example hearing loss and inflammation and in some cases, facial paralysis and brain infections.

Potential treatments include cleaning of the ear and application of ear drops by the doctor or a surgical procedure called tympanoplasty.

3) Otitis Externa

Often referred to as ‘Swimmer’s Ear’ or ‘External Otitis’ to distinguish it from the middle ear forms of otitis described above, Otitis Externa is where the outer ear and ear canal become inflamed, generally from a bacterial infection, although fungal infections and underlying skin conditions can also cause otitis externa. Where the condition is severe, it is referred to as Acute Otitis Externa (AOE).

Symptoms include ear pain, ear swelling and/or skin discolouration. It is painful if the outer ear is pulled or touched and there is sometimes itchiness and/or a discharge from the ear. The main cause is water trapped in the ear.

4) Otitis Media with effusion

More commonly known as ‘glue ear’, this is where there is a build up of a sticky substance behind the ear drum in the middle ear. This generally only occurs in children and is quite common in babies and young children.  Ear infections are very prevalent in children – 80% of children contract ear infections at some stage – as any fluid buildup drains away more slowly because the workings of the ear are much smaller. Many children with glue ear have no symptoms and the condition can disappear on its own in three to six months.

If glue ear does not clear up by itself, ‘grommets’ (more information about grommets can be found here) can be inserted or a process called auto-inflation where the child blows into a special balloon.

5) Chronic suppurative otitis media

This is the medical term that describes a persistent ear infection which has resulted in a perforated eardrum.

Other diseases/abnormalities


This is a condition that affects the ossicles (see above) in the middle ear and is a buildup of bone like tissue that stops the ossicles from functioning. It is a progressive condition that causes hearing loss, which may become permanent if not treated in time. Treatment options include fitting a hearing aid, or in some cases surgery to insert artificial ossicles.

Meniere's Disease

Meniere’s disease affects the inner ear and causes hearing loss and affects balance, with dizziness, tinnitus (a ringing sound in the ears) and ear pain other symptoms of the condition. Treatment depends on each individual case, but may include medication or surgery. Around 60% of sufferers can control the condition with a change of diet or by using medication or special devices which send pulses of air into the ear.

If you are suffering from any of the symptoms described above our recommendation would be for you to see your GP for a referral for a consultation with Dr Chang.